Harris County Commissioners took an early look at a fiscal 2013 budget on Tuesday that, at the moment, is a lot like the one they approved last year at this time.

Preliminary estimates place the available general funds at roughly $1.3 billion for the March 2012 through February 2013 period with reserves improved recently, but still significantly lower than levels prior to the 2008 economic downturn.

Rebuilding reserves is seen as crucial, according to the county audit, both for stability and to maintain bond ratings.

”The best way to accomplish this is to limit spending to the amount of new revenue, including that coming in during the year,” County Budget Officer William Jackson said.

David Lopez, president of the Harris County Hospital District, told commissioners the district will “break even,” but health-care reforms will significantly increase the number of residents who qualify for Medicaid beginning in 2014.

“We feel our emphasis on out-patient care is the way to go,” he said.

Lopez added the district will be trying to provide more care at clinics and health-care centers as a result. The overhaul could mean county hospitals, as a whole, will double their federal money.

Commissioner Steve Radack, of Precinct 3, took that as an opportunity to point to “inadequate” access to health-care centers for residents of the county’s unincorporated areas. He said while 1 in 3,700 city residents have been to health centers only 1 in 22,700 residents of unincorporated areas have done so.

“We’ve been going over this for years,” Radack said. “It’s time we do something about it.”

On a positive note, Jackson said, it appears the Sheriff’s Department, which accounts for nearly one-third of the county’s expenditures, will come in under budget. To some extent, this can be attributed to a reduction in the jail population from 11,000 to 8,600 prisoners.

“It’s tough to budget, because you don’t know what the population will be,” he said.

Regarding personnel, the early budget provides more money for county departments and a reserve to fund part of the extra payroll. Departments will be able to replace personnel who leave, provided the department has adequate funding to do so.

All unfunded positions will be eliminated and any partially funded positions will not be activated without review.

The budget, which still has adjustments to undergo, is expected to be approved March 13.